Table of Contents
Herpes simplex – low magnification
Intraepidermal blister
Herpes simplex
LEGEND
Intraepidermal blister with keratinocyte necrosis and ballooning degeneration
Diffuse or perivascular inflammatory infiltrate composed of lymphocytes and neutrophils
Erythrocyte extravasation
Ballooning degeneration
LEGEND
The term ballooning degeneration encompasses the cytopathic changes caused by Herpes Simplex Virus (HSV), including:
- Pale, round and enlarged keratinocytes
Cytolysis and cell death leading to intraepidermal blister formation
Multinucleated keratinocytes with nuclear molding
Metallic blue-gray nuclei with peripheral margination of chromatin
Ballooning degeneration
LEGEND
Pale, enlarged keratinocytes with metallic gray-blue nuclei
Margination of chromatin to the nuclear periphery
Ballooning degeneration with intraepidermal blister
LEGEND
Pale blue-gray nuclei with marginalized chromatin
Completely apoptotic/necrotic keratinocytes
- Keratinocytes become eosinophilic (pink color) with loss of all components including the nucleus
- Lymphocyte
Erythrocyte extravasation
Ballooning degeneration
Cytolysis creating an intraepidermal blister
Herpes simplex
Round, enlarged keratinocytes of multiple sizes
Pale gray-blue nuclei with chromatin marginalization
Presence of lymphocytes
Herpes-inflammatory infiltrate
LEGEND
The inflammatory infiltrate is often diffuse or perivascular
It typically includes:
Lymphocytes
Neutrophils
Erythrocyte extravasation
Features of leukocytoclastic vasculitis, with destruction of vessel walls, swollen endothelial cells and neutrophilic infiltrates
Herpes simplex – overview
